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In NC, Health Care Advocates Work To Outmaneuver Opponents

With the second open enrollment period for Obamacare ongoing, a coalition of groups is working to fill the role that state governments otherwise would. Many states have been openly hostile to groups working to support the health care law. From NBC's article,

In North Carolina, there’s a staff of dozens of people, led by a director, who are in charge of getting people enrolled in Obamacare. The operation, which serves all of the state’s 100 counties, includes a toll-free number where you can call and set up an appointment with an Obamacare specialist. The staff meets constantly to see if its methods are working, and they are getting results: the state had the ninth highest enrollment in the nation.

Here’s what may surprise you: none of these people work for the state of North Carolina, the federal government or any of North Carolina’s cities. North Carolina may be a purple state during presidential elections, but its state politics right now are very red. The state legislature passed a bill barring North Carolina from expanding Medicaid under the Affordable Care Act, which Republican Gov. Pat McCrory has opposed anyway. The state has also not set up its own health care exchange and has done little to encourage ACA enrollment.

But North Carolina is at the forefront of a strategy being employed in conservative states across the country: Obamacare advocates working around their state governments to implement the law. In Alabama, Georgia, South Carolina, Texas and other states, there is intense organizing by coalitions of groups to sign people up for Obamacare, which started open enrollment on Nov. 15 for its second year. In some states, these efforts are led by openly liberal groups, such as the Texas Organizing Project, which is involved heavily in ACA promotion but also backed Democrat Wendy Davis’ unsuccessful gubernatorial campaign.

In North Carolina, meanwhile, more than 100 groups, mostly non-partisan, have joined the “Big Tent,” ranging from community hospitals to the Legal Aid of North Carolina.

“It really has been a substitute for the state government,” said Lee Dixon, who was the director of the North Carolina initiative during the first year of ACA enrollment. “The role the state government would usually play has been assumed by the Big Tent.”

The need for these outside entities to be involved illustrates the enduring divide over the health care law. Nationally, Republicans in Congress continue to say they will seek to repeal the Affordable Care Act, and the Supreme Court will consider in its upcoming term a case that could radically weaken the law. At stake is whether people in the 36 states that have not set up their own health care exchanges can get the subsidies for insurance under the ACA. The public remains polarized on the law, with Democrats supporting it and most Republicans in opposition.